Effect Of Delivery Mode Research Articles

Are caffeine effects equivalent between different modes of administration: the acute effects of 3 mg.kg-1 caffeine on the muscular strength and power of male university Rugby Union players.

There is growing interest in the potential of alternative modes of caffeine administration for enhancing sports performance. Given that alternative modes may evoke improved physical performance via distinct mechanisms, effects may not be comparable and studies directly comparing the erogenicity of alternative modes of caffeine administration are lacking. To address this knowledge gap, the present study evaluated the effect of 3 mg·kg-1 caffeine delivered in anhydrous form via capsule ingestion, chewing gum or mouth rinsing on measures of muscular strength, power, and strength endurance in male Rugby Union players. Twenty-seven participants completed the study (Mean ± SD: Age 20 ± 2 yrs; daily caffeine consumption 188 ± 88 mg). Following assessments and reassessment of chest press (CP), shoulder press (SP), Deadlift (DL), and Squat (SQ) 1-repetition maximum (1RM) and familiarization to the experimental procedures, participants completed six experimental trials where they were administered 3 mg.kg-1 caffeine (Caff) or placebo (Plac) capsule(CAP), chewing gum(GUM) or mouth rinse(RINSE) in a randomized, double-blind and counterbalanced fashion prior to force platform assessment of countermovement jump, drop jump and isometric mid-thigh pull performance. Strength endurance was measured across two sets of CP, SP, DL, and SQ at 70% 1RM until failure. Pre-exercise perceptions of motivation and arousal were also determined. Caffeine increased perceived readiness to invest mental effort (p = .038; ηp2=.156), countermovement jump height (p = .035; ηp2=.160) and SQ repetitions until failure in the first set (p < .001; d = .481), but there was no effect of delivery mode (p > .687; ηp2<.015). Readiness to invest physical effort, felt arousal, drop jump height, countermovement jump, drop jump and isometric mid-thigh pull ground reaction force-time characteristics and repetitions until failure in CP, SP and DL were not affected by caffeine administration or mode of caffeine delivery (p > .0.052; ηp2< .136). 3 mg.kg-1 caffeine administered via capsule, gum or mouth rinse had limited effects on muscular strength, power, and strength endurance. Small effects of caffeine on CMJ height could not be explained by changes in specific ground reaction force-time characteristics and were not transferable to DJ performance, and effects specific to the SQ RTP exercise underpin the complexity in understanding effects of caffeine on muscular function. Novel modes of caffeine administration proposed to evoke benefits via distinct mechanisms did not offer unique effects, and the small number of effects demonstrated may have little translation to a single performance trial when data examining direct comparison of each caffeine vehicle compared against a mode matched placebo is considered.

Incidence of neonatal respiratory morbidity after vaginal and caesarean delivery in the late-preterm and term period - a retrospective cohort study.

Respiratory distress syndrome is a leading cause of neonatal intensive care unit admissions for late preterm (34-36 weeks gestational age) and term infants (37-41 weeks). The risk for respiratory morbidity appears to increase after an elective caesarean delivery and might be reduced after antenatal corticosteroids. However, before considering antenatal corticosteroids for women at high risk of preterm birth after 34 weeks, the incidence of respiratory distress syndrome and the effect of delivery mode on this incidence requires further evaluation. Therefore, this study aimed to investigate the relationship between respiratory distress syndrome incidence and delivery mode in late preterm and term infants. In this retrospective cohort study, the clinical databases of the University Hospitals of Zurich and Basel were queried regarding all live births between 34 + 0 and 41 + 6 weeks. Neonatal intensive care unit admissions due to respiratory distress syndrome were determined and analysed in regard to the following delivery modes: spontaneous vaginal, operative vaginal, elective caesarean, secondary caesarean and emergency caesarean. After excluding malformations (n = 889) and incomplete or inconclusive data (n = 383), 37,110 infants out of 38,382 were evaluated. Of these, 5.34% (n = 1980) were admitted to a neonatal intensive care unit for respiratory distress syndrome. Regardless of gestational age, respiratory distress syndrome in infants after spontaneous vaginal delivery was 2.92%; for operative vaginal delivery, it was 4.02%; after elective caesarean delivery it was 8.98%; following secondary caesarean delivery, it was 8.45%, and after an emergency caesarean it was 13.3%. The risk of respiratory distress syndrome was higher after an elective caesarean compared to spontaneous vaginal delivery, with an odds ratio (OR), adjusted for gestational age, of 2.31 (95% CI 1.49-3.56) at 34 weeks, OR 5.61 (95% CI 3.39-9.3) at 35 weeks, OR 1.5 (95% CI 0.95-2.38) at 36 weeks, OR 3.28 (95% CI 1.95-5.54) at 37 weeks and OR 2.51 (95% CI 1.65-3.81) at 38 weeks. At 39 weeks, there was no significant difference between the risk of respiratory distress syndrome after an elective caesarean vs. spontaneous vaginal delivery. Over the study period, gestational age at elective caesarean delivery remained stable at 39.3 ± 1.65 weeks. The incidence of respiratory distress syndrome following an elective caesarean is up to threefold higher in infants born with less than 39 weeks gestational age compared to those born by spontaneous vaginal delivery. Therefore - and whenever possible - an elective caesarean delivery should be planned after 38 completed weeks to minimise the risk of respiratory morbidity in neonates.

Effect of delivery mode on Chinese women’s maternal satisfaction: a moderated mediation model of support from medical staff and women’s self-assessment of health

Purpose In recent years, the Chinese government has implemented measures to address the rising rate of cesarean deliveries and promote vaginal births, with the aim of improving women’s childbirth experience. However, non-medically necessary cesarean sections and repeated cesarean sections remain prevalent. This study seeks to explore the correlation between mode of delivery and childbirth experiences. Additionally, it examines the moderating and mediating effects of support from medical staff and women’s self-assessment of health on maternal satisfaction across different delivery methods. Material and Method This cross-sectional survey was conducted with 140 Chinese mothers who were 1–10 days post-partum at three tertiary hospitals. The mothers were asked to fill out a socio-demographic data form and questionnaires related to women’s maternal satisfaction, mode of delivery, self-assessed health, and perception of medical staff support while they were in the hospital after delivery. The data from the questionnaires were analyzed and compared using SPSS 24.0 and PROCESS 3.2. Results This study discovered that the mode of delivery (vaginal birth or C-section) and the perception of support from medical staff significantly influenced maternal satisfaction (β = 0.82, t = 3.42; β = 0.82, t = 10.23). Specifically, women who had a vaginal birth reported higher levels of satisfaction compared to those who had a C-section. The study also found that the perception of medical staff support played a mediating role in this relationship, indicating its influence on women’s satisfaction (β = 0.78, t = 9.58; indirect effect = 0.43, Boot SE = 0.15; 95% CI= [.12–.73]). Furthermore, women’s self-assessed health acted as a moderator in the relationship between the mode of delivery and medical staff support (β = −0.53, t = −2.39; indirect effect = −0.41, Boot SE = 0.19; 95% CI= [–.80–.05]). Conclusion The childbirth experience of Chinese women is greatly influenced by factors such as vaginal birth, their perception of care support from medical staff, and their self-assessment of health. This highlights the importance of healthcare professionals providing women-centered maternity services and childbirth education, which can help reduce unnecessary medical intervention and the need for tertiary obstetric care.

Effect of delivery mode on admission to neonatal intensive care unit in healthy singleton pregnancies.

The aim of this study was to evaluate the short-term results of perinatal health in vaginal and cesarean deliveries and the indications for admission to the neonatal intensive care unit (NICU) in terms of healthy singleton pregnancies. In this study, 300 pregnant women who gave birth in our tertiary hospital was included. The records of newborns admitted to the NICU of these pregnant women were reviewed between January 1, 2019 and January 1, 2021. Durations of newborn hospitalizations and problems encountered during admission were recorded. The results were statistically evaluated. There was no significant difference between vaginal delivery and cesarean section groups in terms of the indications for admission to the NICU of term low-risk pregnant women (p=0.91, p=0.17). A higher admission in the NICU was found in the early term group. The early term group required more respiratory support compared to the full term group (p=0.02). When the groups were compared in terms of IV fluid treatment support, hypoglycemia or feeding difficulty, and jaundice requiring phototherapy, no significant difference was found. Withlimited data available for admission indications to the NICU of newborns born from term pregnancies, we found that the mode of delivery affects hospitalization indications of newborns, need for support, and Apgar scores. Early term delivery is associated with higher rates of neonatal morbidity and admission to the NICU. Better maternal care and prevention of factors that may lead to preterm birth will provide the prevention and management of these problems.

The Effect of Delivery Mode, ABO Blood Type, and Passive Smoking on Postpartum Depression: A Cross-Sectional Study in Saudi Arabia.

Background Postpartum depression (PPD) is a form of depression that can occur after childbirth and is characterized by feelings of sadness. It is a common psychological problem that affects women and children. This study aimed to assess the association between PPD and risk factors, such as delivery mode, ABO blood group, and passive smoking in Saudi Arabia. Methods PPD was assessed in this cross-sectional using an Arabic version of the Edinburgh postnatal depression scale through an online questionnaire distributed to women in Saudi Arabia between January and March 2022. The data were analyzed using SPSS version 26(IBM Corp., Armonk, NY). Results A total of 354 postpartum women completed the questionnaire within six weeks of giving birth. Their mean age and BMI were 30.1±6.78 years and 25.98±5.84 kg/m2, respectively. PPD occurred in 56.2% of the participants. Elective cesarean section and operative vaginal delivery were associated with the presence of PPD symptoms in 17.6% and 7% of the women, respectively. The majority of those with third and fourth degrees and those who had instrumental assisted delivery had postpartum depression and this was statistically significant (p=0.017). About 26.6% of the participants were exposed to passive smoking, and 21.9% of them developed PPD. However, it was not statistically significant. Moreover, women with PPD were more likely to have blood type O+, followed by A+. Demographic factors did not show a significant correlation with developing PPD except for age (p=0.01), those who developed PPD were much younger on average than those who did not develop PPD (29.28±6.61 years vs. 31.15±6.86 years). Conclusion A significant association was found between PPD and the type of delivery. The association between PPD and passive smoking, ABO blood groups was insignificant. However,women who developed PPD were younger on average than those who did not develop PPD.

Perinatal Outcome and Its Association with Blood Pressure Levels in Women with Preeclampsia.

Timing and mode of delivery in women with preeclampsia remains challenging, often balancing the risk of severe maternal complications and preterm delivery with its risks for the newborn. It is known that women with very high blood pressure levels in pregnancy have more unfavourable outcomes, but there is little data on neonatal outcome in these cases and the effect of the delivery mode. We included 158 preeclamptic women in our single-centre retrospective cohort study. Patients were divided into three subgroups depending on blood pressure levels, and delivery mode as well as neonatal outcomes were analysed. Furthermore, the effect of gestational age at delivery was assessed. Maternal blood pressure levels correlated negatively with gestational age at delivery (p = 0.007) and positively with delivery via caesarean section (p = 0.003). Induction of labour was more frequent in women with lower blood pressure levels (p = 0.008) and higher gestational age (p &lt; 0.001). If labour was induced, vaginal delivery was achieved equally often in all gestational ages. Neonatal outcome appears to be more favourable after vaginal delivery compared to planned caesarean section (p &lt; 0.001). Induction of labour should be discussed generously in preeclamptic women, even if blood pressure levels are high and/or gestational age is young, as success rates seem to be adequate and neonatal outcome is more favourable after vaginal delivery. Large prospective trials are needed to better evaluate success rates, risks and complications of induced labour and the effects of delivery mode on neonatal outcome in preeclampsia.

The development of the Language-Independent Speech in Noise and Reverberation test (LISiNaR) and evaluation in listeners with English as a second language

Objective Create a language-independent, ecologically valid auditory processing assessment and evaluate relative stimuli intelligibility in native and non-native English speakers. Design The Language-Independent Speech in Noise and Reverberation Test (LISiNaR) targets comprised consonant-vowel (CVCV) pseudo-words. Distractors comprised CVCVCVCV pseudo-words. Stimuli were presented over headphones using an iPad either face-to-face or remotely. Scoring occurred adaptively to establish a participant’s speech reception threshold in noise (SRT). The listening environment was simulated using reverberant and anechoic head-related transfer functions. In four test conditions, targets originated from 0°. Distractors originated from either ±90°, ±67.5° and ±45° (spatially separated) or 0° azimuth (co-located). Reverberation impact (RI) was calculated as the difference in SRTs between the anechoic and reverberant conditions and spatial advantage (SA) as the difference between the spatially separated and co-located conditions. Study sample Young adult native speakers of Australian (n = 24) and Canadian (25) and non-native English speakers (34). Results No significant effects of language occurred for the test conditions, RI or SA. A small but significant effect of delivery mode occurred for RI. Reverberation impacted SRT by 5 dB relative to anechoic conditions. Conclusion Performance on LISiNaR is not affected by the native language or accent of groups tested in this study.

Maternal anthropometric variables and clinical factors shape neonatal microbiome

Recent studies indicate the existence of a complex microbiome in the meconium of newborns that plays a key role in regulating many host health-related conditions. However, a high variability between studies has been observed so far. In the present study, the meconium microbiome composition and the predicted microbial metabolic pathways were analysed in a consecutive cohort of 96 full-term newborns. The effect of maternal epidemiological variables on meconium diversity was analysed using regression analysis and PERMANOVA. Meconium microbiome composition mainly included Proteobacteria (30.95%), Bacteroidetes (23.17%) and Firmicutes (17.13%), while for predicted metabolic pathways, the most abundant genes belonged to the class “metabolism”. We observed a significant effect of maternal Rh factor on Shannon and Inverse Simpson indexes (p = 0.045 and p = 0.049 respectively) and a significant effect of delivery mode and maternal antibiotic exposure on Jaccard and Bray–Curtis dissimilarities (p = 0.001 and 0.002 respectively), while gestational age was associated with observed richness and Shannon indexes (p = 0.018 and 0.037 respectively), and Jaccard and Bray–Curtis dissimilarities (p = 0.014 and 0.013 respectively). The association involving maternal Rh phenotype suggests a role for host genetics in shaping meconium microbiome prior to the exposition to the most well-known environmental variables, which will influence microbiome maturation in the newborn.

The Microbiota-Gut Axis in Premature Infants: Physio-Pathological Implications.

Intriguing evidence is emerging in regard to the influence of gut microbiota composition and function on host health from the very early stages of life. The development of the saprophytic microflora is conditioned by several factors in infants, and peculiarities have been found for babies born prematurely. This population is particularly exposed to a high risk of infection, postnatal antibiotic treatment, feeding difficulties and neurodevelopmental disabilities. To date, there is still a wide gap in understanding all the determinants and the mechanism behind microbiota disruption and its influence in the development of the most common complications of premature infants. A large body of evidence has emerged during the last decades showing the existence of a bidirectional communication axis involving the gut microbiota, the gut and the brain, defined as the microbiota-gut-brain axis. In this context, given that very few data are available to demonstrate the correlation between microbiota dysbiosis and neurodevelopmental disorders in preterm infants, increasing interest has arisen to better understand the impact of the microbiota-gut-brain axis on the clinical outcomes of premature infants and to clarify how this may lead to alternative preventive, diagnostic and therapeutic strategies. In this review, we explored the current evidence regarding microbiota development in premature infants, focusing on the effects of delivery mode, type of feeding, environmental factors and possible influence of the microbiota-gut-brain axis on preterm clinical outcomes during their hospital stay and on their health status later in life.

Effect of delivery mode on objective and subjective aspects of voice.

This study aimed to compare the effect of delivery on both objective and subjective parameters of voice. This is a prospective parallel-group randomized controlled trial. 105 women grouped in two; vaginal delivery (NG) and cesarean group (CG). The fundamental frequency (F0), jitter, shimmer, noise-to-harmonics ratio (NHR), number of voice breaks (VBn) and percentage of voice breaks (VB%) were determined in acoustic analysis. Voice Handicap Index 30 (VHI) was used for subjective analysis. In NG, a significant decrease in jit%, shim% and VB% was observed (p <.05). In CG, all parameters including F0 showed a significant decrease in early postpartum period (p <.05). CG had more significant improvement in F 0, jit%, shim%, shimdB, VB%, VBn according to test statistics values. VHI scores increased in both NG and CG. The change of objective parameters was more significant in CG. Vaginal delivery may cause vocal trauma which results in deterioration in objective acoustic measures as well as decrease in subjective voice quality.

The Effects of Delivery Mode on the Gut Microbiota and Health: State of Art.

The delivery mode is an important factor driving alteration in the gut microbiota during the neonatal period. Several studies prove that the alteration of gut microbiota induced by cesarean section could influence the activation of intestinal epithelial cells and the development of immune system. Further, some autoimmune and metabolic disorders may be related to the microbiota dysbiosis in infants caused by cesarean section. It is noteworthy that probiotics could promote the intestinal microecology, which may further prevent and treat cesarean section related diseases. This review summarized the great significance of delivery mode on microbiota and health, as well as provided clinically feasible methods for the prevention and treatment of cesarean section related gut diseases.

The mediating effect of the prolonged second stage of labor on delivery mode and urinary incontinence among postpartum women: evidence from Shandong, China.

This study was aimed at exploring the mediating role of the prolonged second stage of labor (PSSL) in the association between delivery mode and urinary incontinence (UI) among postpartum women in Shandong, China. A cross-sectional study involving postnatal women from the Women's Pelvic Floor Functional Health Center in Shandong, China, was conducted. An electronic questionnaire was used to collect the data between June 2020 and February 2021. UI was assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Logistic regression and multiple linear regression were employed to explore the association among delivery mode, PSSL, and UI, and the mediating role of PSSL. Among the total of 5,586 postpartum women included in this study, the prevalence of UI was 13.3%. Among the 742 patients with UI, the prevalence of stress urinary incontinence (78.3%) was greater than urge urinary incontinence (8.6%), mixed urinary incontinence (9.3%), and others (3.8%). After adjusting for controlling variables, delivery mode was found to be significantly associated with PSSL, whereby women with vaginal delivery were more likely to be in PSSL, and women with PSSL had a higher probability of suffering from UI. PSSL played a partial mediating effect in delivery mode and UI. This study provided evidence that the effect of delivery mode on UI was partially mediated by PSSL among postpartum women in Shandong, China. Strategies to prevent PSSL should be actively adopted to reduce the risk of UI in women.

The effect of delivery mode on thiol-disulfide balance in the umbilical cord blood

Amac: Gunumuzde, oksidatif stress seviyesi siklikla thiol-disufid dengesini inceleyen metodlar yoluyla saptanir. Elektif sezaryen (ES) ve vajinal dogumlardaki (VD) oksidatif stresi tihol-disulfid dengesini inceleyerek karsilastirmayi amacladik. Araclar ve Yontem: Calismaya 48 VD ve 57 ES dahil edildi. Calismada, standardizasyon amaciyla, spinal anestezi ile yapilan ES’lar incelendi. Plasenta ayrildiktan hemen sonra umblikal arterden bes mililitre kan ornegi alindi. Serum nativ thiol, total thiol, disulfid analiz edildi. Disulfid/nativ thiol (%), disulfid/total thiol (%), and nativ thiol/total thiol (%) oranlari hesaplandi. Bulgular: ES grubundaki nativ thiol, total thiol, disulfid, and disulfid/total thiol oranlari VD grubundan belirgin olarak dusuktu (446.27±48.01 , 484.26±47.50, p 0.05). Gruplar arasinda yas ortalamasi, dogum haftasi ve dogum agirligi acisindan fark yoktu (p>0.05). ES grubundaki yenidoganlarin ilk ve 5. dakika Apgar skorlari VD grubundan daha yuksekti (p<0.01). Sonuc: Thiol-disulfit dengesi dogum yonteminden etkilenmektedir. Vajinal dogumdaki oxidativ stres seviyesi elektif sezaryendekinden daha yuksektir.

Effects of delivery mode on behavior in mouse offspring

Cesarean section (CS) has been associated with an increased risk of mental disorders in the offspring. This could possibly be explained by an inadequate microbial colonization early in life with a consequential disturbed gut-brain interaction. To investigate the link between delivery mode and behavior and develop a suitable animal model for further research of the gut-brain axis, the aim of this study was to characterize the gut microbiota (GM) together with the behavioral response in various behavioral tests in CS-delivered mice. We hypothesized that mice delivered by CS would present with disturbances in normal physiological behavior possibly due to an inadequate microbial colonization. C57BL/6 mice delivered by CS or vaginal delivery (VD) were cross fostered and, as adults, observed for anxiety-related behavior in the open field test, social deficits in a sociability test and compulsive behavior in the marble burying test. GM was analyzed by 16S rRNA gene amplicon sequencing. The open field test showed that CS-delivered mice had a decreased activity and accelerated defecation compared to VD-delivered mice. In addition, CS-delivered female mice spend less time interacting with cage mates in the sociability test, whereas there was no effect of CS delivery on the average number of marbles buried. In conclusion, CS-delivered mice had a more pronounced anxiety-like behavior and showed less preference for sociability in female offspring.

Gut Microbiota Shift in Obese Adolescents Born by Cesarean Section

Background: It is known that in the early postnatal period a variety of factors affect the gut microbiota (GM) composition, including delivery mode. The effect of delivery mode on the human GM in the late postnatal period remains unexplored. A shift of GM composition due to delivery mode may contribute to the development of obesity in adulthood. Methods and Results: The study included six adolescents aged between 11 and 17 years treated and examined at the Clinic of the Scientific Center for Family Health and Human Reproduction (Irkutsk, Russia) in 2016. Stool samples were collected following the standard operating procedures according to the International Human Microbiome Standards. Metasequencing of V3-V4 variable regions of the 16S rRNA gene was performed by the Novogene Company (China) on the Illumina platform. Bioinformatic analysis was done by the bri-shur.com services. Sequencing reads were presented as normalized values. In general, the GM composition of obese adolescents born by cesarean section was characterized by composition heterogeneity within the Bacteroidetes phylum and the dominance of certain phylotypes as signs of dysbiosis for each adolescent. We detected an increased abundance of phyla Bacteroides and Proteobacteria, and an absence of Tenericutes in obese adolescents born by Caesarean section. On the level of genera, the prevalence of Bacteroides and Bacteroides S24-7 phylotypes, and the absence of the RF39 phylotype, led to the GM shift associated with a cesarean section or obesity. Conclusion: Obese adolescents born by cesarean section delivery present the shift in GM composition.

Effect of delivery mode on neonate auditory brainstem responses to air- and bone-conducted stimuli

ObjectivesThe object of this study was to examine if caesarean section delivered neonates have different middle ear function relative to neonates with vaginal delivery. MethodsAuditory brainstem responses (ABRs) were examined in caesarean section delivered (n = 23) and vaginally delivered (n = 29) neonates. ABRs were also evoked with air- and bone-conducted stimuli (i.e., clicks and CE-Chirps) and presented at a screening intensity level (i.e., 30 dB nHL). Wave V latencies and amplitudes were examined as a function of mode of delivery and stimuli. ResultsStatistically significant longer wave V latencies evoked with air-conducted stimuli were seen in caesarean section delivered neonates (p = .042). There was no statistically significant difference in wave V latencies with bone-conducted stimuli among the two groups of neonates (p = .42). There were no significant differences in wave V amplitude between neonates with caesarean section and vaginal delivery for air-conducted (p = .42) stimuli. Wave V amplitudes were not significantly different as a function of mode of delivery with CE-Chirp stimulus (p = .41). Wave V amplitudes were significantly larger for the caesarean section delivered neonates with the bone-conducted click stimulus (p = .036). ConclusionsThe ABR wave V latency disparity with air- and bone-conducted stimuli support the notion that differences in middle ear function exist between the two groups of newborns. It was speculated that delayed fluid resorption in the middle ear exists in neonates with caesarean section delivery compared to those with vaginal delivery.

VP56.05: The effect of delivery mode on pelvic floor measured by 2D, 3D and elastography at six weeks postpartum

VP56.05: The effect of delivery mode on pelvic floor measured by 2D, 3D and elastography at six weeks postpartum

Ethnic diversity in infant gut microbiota is apparent before the introduction of complementary diets

ABSTRACT The human gut microbiota develops soon after birth and can acquire inter-individual variation upon exposure to intrinsic and environmental cues. However, inter-individual variation has not been comprehensively assessed in a multi-ethnic study. We studied a longitudinal birth cohort of 106 infants of three Asian ethnicities (Chinese, Malay, and Indian) that resided in the same geographical location (Singapore). Specific and temporal influences of ethnicity, mode of delivery, breastfeeding status, gestational age, birthweight, gender, and maternal education on the development of the gut microbiota in the first 2 years of life were studied. Mode of delivery, breastfeeding status, and ethnicity were identified as the main factors influencing the compositional development of the gut microbiota. Effects of delivery mode and breastfeeding status lasted until 6M and 3M, respectively, with the primary impact on the diversity and temporal colonization of the genera Bacteroides and Bifidobacterium. The effect of ethnicity was apparent at 3M post-birth, even before the introduction of weaning (complementary) foods, and remained significant after adjusting for delivery mode and breastfeeding status. Ethnic influences remained significant until 12M in the Indian and Chinese infants. The microbiota of Indian infants was characterized by higher abundances of Bifidobacterium and Lactobacillus, while Chinese infants had higher abundances of Bacteroides and Akkermansia. These findings provide a detailed insight into the specific and temporal influences of early life factors and ethnicity in the development of the human gut microbiota. Trial Registration: Clinicaltrials.gov registration no. NCT01174875.

Is cesarean section a cause of affective disorders?—A national cohort study using sibling designs

BackgroundThe gut microbiota of children delivered by cesarean section differs from that of children delivered vaginally. In light of the gut-brain axis hypothesis, cesarean section may influence risk of affective disorders. MethodsPopulation based prospective cohort study included Danish children born 1982 through 2001, with follow-up until 2015. The effect of delivery mode on the risk of affective disorders was assessed using a standard Cox model and two types of Cox sibling models. Diagnostic codes or prescriptions for antidepressants and lithium were used to define cases of affective disorders. Results1,009,444 children were followed for 8,880,794 person-years from the age of 13 years, with relevant covariates available from birth. There are strong calendar time trends in the occurrence of affective disorders with an increasingly younger age at first diagnosis and with a hotspot between the years 2007–2012. Fully adjusted standard Cox models showed an increased risk of affective disorders for both pre-labor (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.08–1.15) and intrapartum (HR, 1.07; 95% CI, 1.05–1.10) cesarean section, compared to vaginal delivery. This effect disappeared in the between–within sibling model for pre-labor (HR, 1.00; 95% CI, 0.94–1.07) but not intrapartum (HR, 1.05; 95% CI, 1.00–1.12) cesarean section. LimitationsInterpretation of results from sibling models may not be relevant to children without siblings. ConclusionsThese results do not support the hypothesis that a delivery-mode dependent change in gut microbiota is a cause of subsequent affective disorders, despite an apparent association with delivery mode.

Assessment of breath sounds at birth using digital stethoscope technology

Newborn transition is a phase of complex change involving lung fluid clearance and lung aeration. We aimed to use a digital stethoscope (DS) to assess the change in breath sound characteristics over the first 2h of life and its relationship to mode of delivery. A commercially available DS was used to record breath sounds of term newborns at 1-min and 2-h post-delivery via normal vaginal delivery (NVD) or elective caesarean section (CS). Sound analysis was conducted, and two comparisons were carried out: change in frequency profiles over 2h, and effect of delivery mode. There was a significant drop in the frequency profile of breath sounds from 1min to 2h with mean (SD) frequency decreasing from 333.74 (35.42) to 302.71 (47.19) Hz, p < 0.001, and proportion of power (SD) in the lowest frequency band increasing from 0.27 (0.11) to 0.37 (0.15), p < 0.001. At 1min, NVD infants had slightly higher frequency than CS but no difference at 2h.Conclusion: We were able to use DS technology in the transitioning infant to depict significant changes to breath sound characteristics over the first 2h of life, reflecting the process of lung aeration.What is Known:• Lung fluid clearance and lung aeration are critical processes that facilitate respiration and mode of delivery can impact this• Digital stethoscopes offer enhanced auscultation and have been used in the paediatric population for the assessment of pulmonary and cardiac soundsWhat is New:• This is the first study to use digital stethoscope technology to assess breath sounds at birth• We describe a change in breath sound characteristics over the first 2h of life and suggest a predictive utility of this analysis to predict the development of respiratory distress in newborns prior to the onset of symptoms.